S8 L2 Lower GI Malignancy Flashcards
Lower GI Malignancy
- Three key symptoms
- Obstruction
- Per Rectum (PR) bleeding
- Change in bowel habit
Often need to look at these symptoms together
1st Main Symptom: Obstruction
- What is this?
- General symptoms
- Large bowel (lower in GI tract) vs small bowel (higher in GI tract) symptoms, and explain the differences in symptoms
Small bowel - Nausea/vomiting
If malignancy is higher up, pressure will build up backwards.
More likely to present with: Vomiting
Large bowel - Constipation (absolute)
• Less likely to present with vomiting as need significant build up to cause this
• Constipation: ‘Absolute constipation’ (not passing any feacal matter or wind) must ask a patient if they are passing wind, as at risk of bowel perforation (could lead to peritonitis and then sepsis
Differentials for Obstruction
Red Flags - Obstruction
- Unintential weight loss
- Unexplained abdominal pain (i.e. not being able to find a reason for the pain)
2nd Main Symptom: PR Bleeding
- Differntial Diagnosis
- Nature of bleeding
PR Bleeding
- Red flags
3rd Main Symptom: Change in bowel habit
- Type of changes that can occur…
- Differentials for Change in Bowel habit
- Red flags
Many benign causes of change in bowel habit!
• Age dependent
• Iron deficiency anaemia
• Unexplained weight loss
• PR blood loss
Large Bowel Cancer
- Main type of large bowel cancer
- Prevalence
- Risk factors for it
- Screening - how is this done? which group of people? who can have more reguar screens?
Transistion from Polyps to Adenocarcinoma…
Large Bowel cancer:
Right sided colon cancer vs Left sided colon cancer
- Signs and symptoms
- Differences in signs and symptoms
- Prognosis differences…
What may a left sided colon cancer look like with barium enema?
Small Bowel Cancer
- Prevalance?
- Different types…
- Risk factors…
- Symptoms…
General Management:
- Diagnosis (3 main types)
TNM staging
Duke’s Staging